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General NPI Number Information
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NPI Number | 1861908576
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Entity Type | Individual
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Provider Name | MATTHEW SCHULKE PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 1300 DACY LN STE 120-130
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City | KYLE
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State | TX
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Zip | 78640-4192
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Country | US
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Telephone | 512-392-8953
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Fax | 512-262-7505
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Provider Business Mailing Address
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Address Line | 819 WATER ST
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City | KERRVILLE
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State | TX
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Zip | 78028-5333
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Country | US
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Telephone | 830-792-7505
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Fax | 830-792-5771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 899253
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1175658
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License Number State | TX
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